Borderline Personality Disorder Treatment and Eating Disorders

Treating eating disorders can be very challenging. Especially among those with anorexia, there is a high relapse rate, because patients often have a very difficult time applying what they have learned in treatment when they re-enter normal life.

A new study examined the effectiveness of applying a treatment to eating disorder patients that has been successful in treating those with borderline personality disorder (BPD). The strategy was attempted because there is a high rate of eating disorders among those with BPD. The treatment is called Dialectical Behavior Therapy.

Dialectical Behavior Therapy (DBT) is a cognitive-behavior therapy that was designed for women struggling with borderline personality disorder. BPD is diagnosed in patients who have multiple suicidal episodes and multiple problem behaviors.

The therapy used in DBT offers training in life skills, using a comprehensive approach to target behaviors that are life-threatening and help the patient to establish a higher quality of life. The patient is trained to recognize patterns of emotions in order to navigate possible extremes.

The study was led by Dr. Eunice Y. Chen from the University of Chicago in Illinois and colleagues. The researchers examined the effectiveness of DBT in eight women diagnosed with borderline personality disorder and either bulimia or binge-eating disorder. The therapy consisted of weekly skills group training, therapist consultation team meetings, and telephone coaching.

Four of the women had required emergency treatment for a suicide attempt or an attempt at self-injury during the last 12 months before the study. Six of the participants were being treated with psychotropic medications.

The results of the study were published in the International Journal of Eating Disorders, where Chen reported that DBT was successful in treating social functioning and reducing self-injury behaviors and suicidal attempts. The therapy was also effective at treating binge-eating behaviors and thoughts about eating disorders.

Dr. Chen and colleagues reported that six months of treatment may not be sufficient for effectively treating eating disorders with DBT. There was one suicide attempt made by one participant within six months of treatment and several of the participants told therapists that they felt the training was too short.

Using DBT may be an effective treatment for those struggling with eating disorders. It may be necessary to extend the training to a longer period, or to offer a tapering treatment schedule, where telephone access to therapists is available for an extended length of time towards the end of treatment.